SWALLOWING PROBLEMS IN NEUROMUSCULAR DISORDERS

Feeding problems in patients with neuromuscular diseases are frequentl y underestimated and poorly analyzed. To gain a better understanding o f the most common complaints, we surveyed 451 patients and received 40 9 responses representing seven disorders. Difficulties in the pre-oral phase of swallowing were encountered primarily in Duchenne muscular d ystrophy (DMD), limb-girdle muscular dystrophy (LGMD), facio-scapulo-h umoral muscular dystrophy (FSHMD), and spinal muscular atrophy (SMA). A limitation in the ability to open the mouth was also noted in SMA. S ome features are characteristic of certain diseases such as macrogloss ia in DMD and dryness of the mouth in dermatomyositis and polymyositis (DMPM) and myasthenia gravis (MG). Posterior swallowing time is espec ially affected in MG, dermatomyositis and polymyositis, LGMD, and SMA. Overall prevalence of feeding disability in five disorders (SMA, myot onic dystrophy [MD], DMPM, FSHMD, MG) was 34.9%. A better understandin g of the swallowing problems associated with these disorders may help in choosing treatment possibilities, technical aids, adaptation of the consistency of foods, swallowing rehabilitation, and nutritional supp ort by the non-oral route.